SEARCH · PubMed Health

Results for “parotidectomy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources

PubMed2005

The role of imaging and surgery in the management of vascular tumors of the masseter muscle.

PURPOSE: Intramuscular vascular malformations are uncommon lesions in the head and neck that may mimic salivary gland disease. This study reports on the use of various imaging modalities and recommends a surgical approach in the management of vascular malformations of the masseter muscle. PATIENTS AND METHODS: This is a retrospective study of 7 consecutive patients with vascular tumors of the masseter muscle treated in one unit between 1995 and 2004. The age, gender, signs and symptoms, imaging methods, and surgical outcome are reported. A previously unreported surgical approach is described. RESULTS: All patients had atypical swellings in and around the parotid region that were difficult to diagnose on plain radiography and computed tomography. Magnetic resonance imaging provides accurate three-dimensional images and provisional diagnosis of lesions within the masseter muscle. Six of the 7 patients underwent surgery by the recommended approach. No patients developed permanent facial weakness following modified parotidectomy. No recurrence of the vascular tumors occurred when the recommended approach is used. CONCLUSIONS: Magnetic resonance imaging remains the imaging modality of choice for the management of tumors of the masseter muscle. The extended parotidectomy approach gives good and safe surgical access in the management of these uncommon lesions.

Adolescent↗

PubMed2005

Sonohistology for the computerized differentiation of parotid gland tumors.

A system for the computerized differentiation of parotid gland tumors is proposed. The parotid gland is the largest of the salivary glands. It is found in the subcutaneous tissue of the face, overlying the mandibular ramus and anterior and inferior to the external ear. The classification system is based on a multifeature tissue characterization approach, using fuzzy inference systems as higher-order classifiers. Baseband ultrasonic echo data were acquired during conventional ultrasound imaging examinations using standard ultrasound equipment. Several tissue-describing parameters were calculated within numerous small regions of interest to evaluate spectral and textural tissue properties. The parameters were processed by an adaptive network-based fuzzy inference system, using the results of conventional histology after parotidectomy as the "gold standard." The results of the classification are presented as a numerical score indicating the probability of a certain tumor or alteration for each parotid gland. The score can be presented to the physician during examination of the patient to improve the differentiation between various types of parotid gland tumors. The system was evaluated on n = 23 cases of patients undergoing radical parotidectomy. The receiver operating characteristic curve area is A(ROC) = 0.95 +/- 0.07 when using fourfold cross-validation over cases and differentiating between various benign parotid gland tumors and monomorphic adenoma.

Adenoma↗

PubMed1990

Whole organ sectioning of mixed parotid tumors.

A pathologic study involving 15 standard formal parotidectomy specimens was carried out using the whole organ sectioning technique. Histopathologic characteristics noted included the presence of exposed capsule, breaks of the capsule, capsular incompleteness, tumor ingrowth and thickness, cellularity, and lymphocytic infiltration. Tracings of histopathology slides were used to reconstruct the three-dimensional configuration of each tumor as viewed from different angles. No tumor had a smooth surface. At the extreme, two tumor lumps were connected by just a narrow waist. Separated tumors were not seen. In only one specimen did a lymph node contain an additional tumor in the form of an adenolymphoma. All tumors showed some exposed capsule or "bare area" to a degree affected mainly by the position of the tumor. Capsular damage was occasionally seen and was usually minor. Capsular incompleteness and tumor ingrowth make global capsular dissection unsafe. It is concluded that formal parotidectomy remains the operation of choice for pleomorphic adenoma of the parotid gland, although capsular dissection (otherwise termed enucleation) cannot be entirely avoided during the procedure.

Adenoma, Pleomorphic↗

PubMed1997

Malignant tumours of the parotid gland: a 12-year review.

Malignant parotid tumours are uncommon and present a significant management challenge. Fifty-one such patients (25 male, 26 female, median age 64 years) operated on in the Newcastle Plastic Surgery Unit between 1983 and 1994 were retrospectively evaluated. Preoperative investigations included FNA cytology (n = 20), and for staging CT and/or MRI scans (n = 21). Of the 35 primary tumours 32 were epithelial and three lymphomatous. Metastatic tumours were squamous cell carcinoma (7), melanoma (6), renal cell carcinoma (2) and sebaceous carcinoma (1). FNA cytology correctly diagnosed malignancy with an 88% sensitivity (false negatives = 2). A total or radical parotidectomy was required in 60% of patients, the rest undergoing superficial parotidectomy. In continuity neck dissection was undertaken in 23 (45%) cases. Postparotidectomy reconstruction included 10 free, 3 myocutaneous, and 4 local transposition/rotation flaps. Thirty-seven patients (73%) received postoperative radiotherapy. Seventy-two per cent of patients are alive after a mean follow-up of 42 months. The crude 5- and 10-year survival rates were 68% and 49% respectively while the loco-regional control rate (Kaplan-Meier method) at 10 years was 79%. Fifteen patients (30%) have permanent facial palsy. It is concluded that radical surgery with appropriate reconstruction followed by planned postoperative adjuvant radiotherapy gives effective control of malignant parotid tumours.

Adolescent↗

PubMed1989

Effects of atropine injection on food-associated drinking in rats with superior salivatory nucleus lesions.

The neuropharmacological mechanisms involved in the prandial drinking pattern seen in rats with superior salivatory nucleus lesions + parotidectomy were investigated with behavioral methods. Results showed that the administration of low doses (0.1 mg/kg body wt) of atropine in lesioned rats potentiated previously established prandial drinking. Higher doses of atropine (1.0 mg/kg), however, were required to induce a similar degree of prandiality in control rats (parotidectomy alone). These findings suggest that the salivatory nucleus lesions affected a cholinergic brainstem-salivary gland system involved in the neural control of food-associated drinking.

Animals↗

PubMed2001

Duplication of the external auditory canal: a report of three cases.

OBJECTIVE: Malformations of the first branchial cleft are uncommon and only sporadically reported in the literature. They may present as inflammatory openings on the neck, bland cysts or fistula associated with the external auditory canal. In this retrospective study, clinical features and anatomical relationships are described in three pediatric cases. Therapeutical guidelines for surgical management of first branchial cleft anomalies are discussed. PATIENTS: Between 1997 and 1999 three patients aged 9 months, 2 and 7 years with first branchial cleft anomalies were included in this study. All patients were treated surgically, wide exposure and superficial parotidectomy was necessary for complete removal in two of three cases. RESULTS: Exploring patients histories revealed previous infections with repeated incision and drainage procedures as well as inadequate operative resections. Clinically, purulent drainage from the ear, swelling in the parotid area and abscess formation with persistent drainage after incision in the neck or parotid area were noted. CONCLUSIONS: From our case series two of three patients underwent inadequate incision and drainage procedures to combat infection followed by scar tissue formation. Because of the variable relation to the facial nerve this led to difficulties in identifying and protecting the nerve during definite surgery. Management of first branchial cleft anomalies must include the facilities to achieve ear surgery and superficial parotidectomy including facial nerve exposure.

Branchial Region↗

PubMed1999

Treatment of recurrent pleomorphic adenomas of the parotid gland.

Recurrent pleomorphic adenomas (RPAs) of the parotid gland are an uncommon but challenging problem. The records of 31 patients with RPAs were reviewed to assess the clinical presentation and treatment results. More than half of these patients underwent total parotidectomy. Local control was achieved in 94% of patients at 7 years (median follow-up 7.3 years). Patients who had surgery for recurrence after a formal parotidectomy were more likely to have another recurrence (63% local control at 7 years) than patients whose initial procedure was a limited excision (100% local control at 7 years; P < 0.01). Better local control was seen in 11 patients who received postoperative irradiation (100% at 10 years) than in 20 patients who did not (71% at 10 years; P < 0.28). Adequate surgical resection yields an acceptable local control rate in patients with RPAs. Postoperative radiation therapy may improve control in patients at high risk for another recurrence.

Adenoma, Pleomorphic↗

PubMed1998

Local excision of the parotid gland in the treatment of Warthin's tumour.

The results of local excision of Warthin's tumour in the parotid gland (n = 61) (resection of the tumour together with surrounding normal gland and associated lymph nodes) were compared with those of superficial parotidectomy (n = 88) for incidence of recurrence, duration of operation, and degree of facial deformity. A subgroup of patients in each group were tested for gustatory sweating (iodine starch test) and parotid function (quantitative scintigraphy). Local excision had the following advantages over superficial parotidectomy: shorter operating time, less risk of facial nerve damage, less facial deformity, lower incidence of Frey's syndrome, and better preservation of the function of the parotid gland.

Adenolymphoma↗

PubMed1983

Parotid benign tumors: comments on surgical treatment of 263 cases.

263 patients with benign parotid gland tumors have been operated upon, from 1970 through 1980. Of this total number of tumors, according to their histopathologic examination, 185 corresponded to pleomorphic adenoma, 24 to Warthin's tumor, 10 to recurrent pleomorphic adenomas (at first operated on elsewhere) and 44 to miscellaneous tumors or tumor-like lesions (simple cyst, lymphoepithelial lesion, branchial cleft cysts, lymph node hyperplasia etc.). 25 cases of pleomorphic adenoma, operated on during the past 24 months, were not evaluated as far as recurrence is concerned, because their follow-up was insufficiently long. The operative procedures used by us for pleomorphic adenoma surgery were: (a) pericapsular (extracapsular) excision, with a margin of normal parotid gland tissue without preparation of the fascial nerve, for 98 small size and superficially sited pleomorphic adenomas (52.6%); (b) subtotal parotidectomy (superficial lobectomy) with preparation of the facial nerve for 78 tumors (42.5%); (c) total parotidectomy with preservation of the nerve for 9 tumors located on the deep lobe of the gland (4.9%). We did not see any permanent facial palsy, and not one case of recurrence.

Adenoma, Pleomorphic↗

PubMed2002

Pleomorphic adenoma of the parotid gland: is long-term follow-up needed?

INTRODUCTION: Pleomorphic adenoma is a slow-growing benign salivary tumour most commonly arising in the parotid gland. Macroscopically it has a surrounding capsule from which it can be enucleated-often the treatment used in the past. These tumours do not have a true capsule but can press surrounding normal salivary gland, frequently having finger-like extensions into the normal tissues. Recurrence, or more accurately residual disease, is thought to be due to these small islands of tumour which can be left behind at surgery, in particular enucleation which is associated with high recurrence rate. The current, most common practice is the excision of these tumours through superficial parotidectomy and postoperative follow-up. However, is long-term follow-up necessary and does it reduce the morbidity from tumour recurrence? METHODS: We reviewed the charts of 182 patients who underwent parotid surgery operated upon by a single surgeon (RKM) between 1973 and 1999. We included only 58 cases of pleomorphic adenomas removed by superficial parotidectomy. We excluded cases that had follow-up of less than 12 months and cases which had previous surgery elsewhere. Adequate tumour excision and the integrity of the capsule were ascertained intra-operatively, and this was confirmed by postoperative histology. RESULTS: In our study we had 34 females, mean age of 58, and 24 males, mean age of 50. The average follow-up was 6 years with a range of 1-23 years. We had no permanent facial nerve dysfunction, and we recorded only one recurrence (1.7%). CONCLUSION: Provided adequate excision of the tumour with intact capsule and histological confirmation are achieved, long-term follow-up is unnecessary and can be replaced by patient education and self-examination.

Adenoma, Pleomorphic↗

PubMed1999

A device for applying postsurgical pressure to the lateral face.

OBJECTIVE: The purpose of this study was to improve the effect of pressure applied on the lateral face after operations, particularly after parotid surgery for prevention of complications, especially the formation of salivary fistula. STUDY DESIGN: A pressure instrument (face pad) was designed to fit all types of facial morphology. The blood flow velocity of the superficial temporal artery was measured by means of a Doppler detector in 30 healthy volunteers under 2 different conditions, with and without the face pad. Values for 2 parameters, peak velocity and average peak velocity, were determined for the purpose of selecting an appropriate pressure. Each of 47 patients who had undergone regional parotidectomy received pressure with the face pad for 3 days; the results were compared with those in a control group of 44 patients who had undergone similar operations but received traditional packing dressings. RESULTS: The peak velocities of the superficial temporal artery with and without the face pad were not significantly different (t = 1.541, P = .132) when a pressure value of 4 to 5 N was applied. However, the average peak velocity of the superficial temporal artery increased significantly (t = 3.678, P = .001) with the face pad. The 47 patients with the face pad had no postoperative parotid fistula; in contrast, salivary fistula developed in 5 of the 44 control cases, for an overall fistula rate of 11.36%. A significant difference existed between the 2 groups (P = .023). CONCLUSIONS: The face pad worked quantitatively and was stable and comfortable. A pressure of 4 to 5 N on the lateral face did not influence the blood flow of the superficial temporal artery. The higher peak velocity was correlated with regional stenosis of the temporal vein caused by pressure. Evidently, the face pad can reduce postoperative complications after parotidectomy; moreover, it makes pressure dressing easy and shortens the in-hospital days of the patient as well.

Adult↗

PubMed1990

Management of parotid metastases from cutaneous melanoma of the head and neck.

Parotid metastases from a cutaneous malignant melanoma are uncommon. Although the long-term prognosis is poor, loco-regional palliation is important. In a group of eight patients with parotid metastases, local control was obtained by superficial parotidectomy. Occult cervical lymph node metastases were identified in five cases in whom radical neck dissection provided regional control. Superficial parotidectomy with elective neck dissection is advocated for patients with parotid metastases from cutaneous melanoma to ensure optimal loco-regional palliation.

Adult↗

PubMed1993

Recurrent pleomorphic adenoma.

Of 209 cases of pleomorphic adenoma treated in a 30 year period, 38 were secondary referrals with recurrent disease following surgery. Of these, 25 were women and 13 men with a mean time to recurrence of 9 years 4 months. Thirty-four recurrences were in the parotid gland, three in the submandibular gland and one in the anterior faucial pillar. Seven patients were untreated due to poor general condition or refusal of further treatment. Of the remainder, 15 had superficial parotidectomy and excision of the scar and nine a total parotidectomy. Three of these had extensive surgery with local flap repair. Of the patients with submandibular gland recurrence, two had local excision and one was treated with radiotherapy alone. One patient had a recurrence in the faucial pillar. Three patients developed malignant change in the recurrent tumour, of whom one died of disease.

Adenoma, Pleomorphic↗

PubMed1996

The deep parotid lymph nodes: an anatomical and oncological study.

In order to better define the anatomical and clinical importance of the deep parotid lymph nodes, the surgical specimens obtained from a series of 18 total parotidectomies were evaluated. In 10 cases primary parotid pathology was found, whereas in the remaining eight cases metastases to glandular lymph nodes were present. One hundred and forty-nine lymph nodes, in all, were identified (range 3-14, average 8.2, mean 8), 118 located in the superficial parotid lobe (range 3-11, average 6.5, mean 7), and 31 in the deep lobe (range 0-5, average 1.7, mean 2). In the group of patients with oncological pathology, of the total 64 lymph nodes examined, 21 were found to be sites of metastasis, 11 in the superficial lobe, and 10 in the deep lobe. The above findings confirm the anatomical and oncological importance of the deep parotid lymph nodes, and highlight the necessity of a total parotidectomy in all cases in which intraglandular spread of lymph node metastases is certain or suspect.

Adenocarcinoma↗

PubMed2003

Extracapsular dissection for clinically benign parotid lumps: reduced morbidity without oncological compromise.

Previous studies have shown that extracapsular dissection (ECD) is an alternative approach to superficial parotidectomy (SP) for pleomorphic adenoma parotid tumours, associated with low recurrence rates equal to those following SP, but with significantly reduced morbidity. However, if a malignant tumour masquerades as a clinically benign lump, this approach may be inappropriate. This study addressed this question by analysing the outcome of 821 consecutive patients with parotid tumours treated at one centre over 40 years and with a median 12 (range 5-30) years follow-up. Tumours were classified as 'simple' (discrete, mobile, < 4 cm: n=662) and 'complex' (deep, fixed, facial nerve palsy, > or =4 cm: n=159). Among the 'simple' or clinically benign tumours, 503 patients underwent ECD; 159 patients underwent SP. In all, 32 (5%) clinically benign cases were subsequently revealed as malignant histologies (ECD, 12; SP, 20). For each group, 5- and 10-year cancer-specific survival rates were 100 and 98%, respectively. There were no differences in recurrence rates when subanalysed by surgical groups, but ECD was associated with significantly reduced morbidity (P < 0.001). This study demonstrates that ECD is a viable alternative to superficial parotidectomy for the majority of parotid tumours, associated with reduced morbidity without oncological compromise.

Adolescent↗

PubMed2001

Sialolipoma: a report of seven cases of a new variant of salivary gland lipoma.

AIMS: We propose the designation 'sialolipoma' to establish and characterize a new category of benign lipomatous tumour occurring in salivary glands. Until now, these tumours have not been regarded as a distinct entity in the salivary glands. METHODS AND RESULTS: We evaluated the clinicopathological and immunohistochemical features of seven sialolipomas among 2051 surgically resected primary salivary gland tumours deposited in our files. The seven patients with sialolipoma were five men and two women, aged 20-75 years (mean: 54.4 years). Five tumours had arisen in the parotid gland, one in the soft palate, and one in the hard palate. The tumours ranged from 10 to 60 mm (mean: 38 mm) in maximum diameter. Histologically, the tumours were characterized by a well circumscribed mass composed of glandular tissue and mature adipose elements. The adipose elements in the tumours arising in the parotid gland were more abundant than those arising in the minor salivary gland. The glandular components consisted of ductal, acinar, basal and myoepithelial cells, and closely resembled the cellular and structural compositions of normal salivary gland tissues. These findings were confirmed by immunohistochemical and ultrastructural studies. These components had no atypia, except for the presence of some minor variations, e.g. ductal ectasia with fibrosis and focal oncocytic metaplasia. In all cases, cell proliferative activity, as assessed by Ki67 (MIB1) immunostaining, was low. From these findings, it is likely that our cases were lipomas with secondary entrapment of the salivary gland elements. No recurrence was seen in all cases after superficial parotidectomy, or after surgical excision in the patients with palatal tumours. CONCLUSIONS: We regard sialolipoma as a distinct variant of salivary gland lipoma that can occur in both the major and minor salivary glands. Superficial parotidectomy, or surgical resection in the case of palatal tumours, is an appropriate treatment for this benign tumour.

Adult↗

PubMed2003

Metastatic cutaneous squamous cell carcinoma to the parotid: the role of surgery and adjuvant radiotherapy to achieve best outcome.

BACKGROUND: Australia has the highest incidence of cutaneous squamous cell carcinoma in the world. The majority of lesions occur in the head and neck with metastases to the parotid gland lymph nodes reflecting an uncommon, but aggressive, manifestation. Parotidectomy +/- neck dissection followed by adjuvant radiotherapy should be considered as best practice. METHODS: Between 1983 and 2000, seventy-four patients were treated for metastatic cutaneous squamous cell carcinoma to the parotid with surgery and adjuvant radiotherapy at Westmead Hospital, Sydney. Relevant data were extracted from patient files and a prospectively maintained database. Patterns of relapse and outcome were analysed. RESULTS: Median age at diagnosis was 65 years (34-93 years) in 63 men and 11 women. Median follow-up duration was 41 months (12-188 months). All patients underwent parotidectomy with 52 undergoing a simultaneous neck dissection. Twelve patients required sacrifice of the facial nerve (4) or one or more branches (8). All received adjuvant radiotherapy to the parotid region with 56 also receiving radiotherapy to the ipsilateral neck. Despite treatment, 24% developed locoregional recurrence, with a median time to relapse of 7.5 months. The most common site for recurrence was the treated parotid region and upper neck. Most relapsed patients died. No variable independently predicted for locoregional recurrence on multivariate analysis. The 5-year absolute and cause-specific survival rates were 58% and 72%, respectively. CONCLUSION: Parotid gland lymph node metastases from cutaneous squamous cell carcinoma are associated with a high rate of recurrence and cause-specific mortality despite current best practice (surgery and high dose adjuvant radiotherapy). The role of more aggressive surgery, altered fractionation or chemotherapy to enhance locoregional control remains unclear.

Adult↗

PubMed1999

Relation of preoperative sialographic findings with histopathological diagnosis in cases of obstructive sialadenitis of the parotid and submandibular glands: retrospective study.

The clinical records, preoperative sialograms and histopathological slides of 33 patients who had been operated on for symptoms of obstructive salivary gland disease were reviewed. Twenty patients had had superficial parotidectomy and 13 excision of the submandibular gland. Among those who had required parotidectomy, preoperative sialograms tended to suggest more architectural damage than was actually noted on definitive histopathological examination. Patients whose symptoms had been present for longer had more severe sialographic and histopathological changes. In the submandibular group, there was a closer relation between sialographic and histopathological changes, and a positive correlation between a short history and the severity of histopathological grading. These differences may reflect the different aetiology and course of obstructive disease in the two types of gland.

Adult↗